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A Revolution in Transcatheter Mitral Valve Intervention
Transcatheter Mitral Valve Intervention
PREFACE A Revolution in Transcatheter Mitral Valve Intervention
Jason H. Rogers, MD, FACC, FSCAI Editor
The field of interventional structural heart disease has grown rapidly in the last decade with the introduction of numerous innovations in diagnosis, imaging, and treatment. The initial growth of this new specialty was fueled heavily by the evidence-based commercial approval of transcatheter aortic valve replacement. This therapy has continued to mature and has seen widespread adoption. Interventional therapies for mitral valve disease, and in particular mitral regurgitation, have been slower to develop given the heterogeneity of mitral valve disease states, the anatomic complexity of the mitral valve apparatus, and the challenges of imaging and delivering therapy to the left side of the heart. Despite these challenges, tremendous advances have been made in this field, and although only a few devices have commercial approval at this time, literally dozens of other approaches to mitral valve repair and replacement are under development at various stages of preclinical and early clinical investigation. The clinical need for less invasive therapies for mitral valve disease is undisputed, especially in patients with systolic heart failure and concomitant mitral regurgitation. The fields of interventional cardiology and cardiac surgery are evolving toward utilizing effective transcatheter therapies for mitral valve correction in patients at high surgical risk, with the hope that these technologies will mature to a point where they can be considered a viable
alternative therapy in intermediate and lower risk patients. In this issue of Interventional Cardiology Clinics, the reader will find reviews on various topics relevant to transcatheter mitral valve intervention by thought-leaders from around the globe. This issue begins with an excellent article on the normal mitral valve anatomy as well as pathologic disease states. Next, echocardiographic and computed tomographic imaging are covered, followed by procedural and data summaries of mitral paravalvular leak closure, transseptal puncture, and MitraClip therapy for primary and secondary MR. Coronary sinusbased and direct annular approaches to mitral annuloplasty are covered, and the issue concludes with exciting updates on transcatheter mitral valve and valve-in-valve replacement. Our gratitude goes to the all the contributors to this focus issue, and we hope that you enjoy this unique collection of articles dedicated to the mitral valve revolution. Jason H. Rogers, MD, FACC, FSCAI Professor, Cardiovascular Medicine Director, Interventional Cardiology University of California, Davis Medical Center 4860 Y Street, Suite 2820 Sacramento, CA 95817, USA E-mail address: [email protected]
Intervent Cardiol Clin 5 (2016) ix http://dx.doi.org/10.1016/j.iccl.2015.10.001 2211-7458/16/$ – see front matter ª 2016 Published by Elsevier Inc.
PREFACE A Revolution in Transcatheter Mitral Valve Intervention
Jason H. Rogers, MD, FACC, FSCAI Editor
The field of interventional structural heart disease has grown rapidly in the last decade with the introduction of numerous innovations in diagnosis, imaging, and treatment. The initial growth of this new specialty was fueled heavily by the evidence-based commercial approval of transcatheter aortic valve replacement. This therapy has continued to mature and has seen widespread adoption. Interventional therapies for mitral valve disease, and in particular mitral regurgitation, have been slower to develop given the heterogeneity of mitral valve disease states, the anatomic complexity of the mitral valve apparatus, and the challenges of imaging and delivering therapy to the left side of the heart. Despite these challenges, tremendous advances have been made in this field, and although only a few devices have commercial approval at this time, literally dozens of other approaches to mitral valve repair and replacement are under development at various stages of preclinical and early clinical investigation. The clinical need for less invasive therapies for mitral valve disease is undisputed, especially in patients with systolic heart failure and concomitant mitral regurgitation. The fields of interventional cardiology and cardiac surgery are evolving toward utilizing effective transcatheter therapies for mitral valve correction in patients at high surgical risk, with the hope that these technologies will mature to a point where they can be considered a viable
alternative therapy in intermediate and lower risk patients. In this issue of Interventional Cardiology Clinics, the reader will find reviews on various topics relevant to transcatheter mitral valve intervention by thought-leaders from around the globe. This issue begins with an excellent article on the normal mitral valve anatomy as well as pathologic disease states. Next, echocardiographic and computed tomographic imaging are covered, followed by procedural and data summaries of mitral paravalvular leak closure, transseptal puncture, and MitraClip therapy for primary and secondary MR. Coronary sinusbased and direct annular approaches to mitral annuloplasty are covered, and the issue concludes with exciting updates on transcatheter mitral valve and valve-in-valve replacement. Our gratitude goes to the all the contributors to this focus issue, and we hope that you enjoy this unique collection of articles dedicated to the mitral valve revolution. Jason H. Rogers, MD, FACC, FSCAI Professor, Cardiovascular Medicine Director, Interventional Cardiology University of California, Davis Medical Center 4860 Y Street, Suite 2820 Sacramento, CA 95817, USA E-mail address: [email protected]
Intervent Cardiol Clin 5 (2016) ix http://dx.doi.org/10.1016/j.iccl.2015.10.001 2211-7458/16/$ – see front matter ª 2016 Published by Elsevier Inc.